Admission Heart Rate Variability is Associated with Fever Development in Patients with Intracerebral Hemorrhage

Area of Science:

• Neurology
• Cardiology
• Critical Care Medicine

Background:

• Fever post-intracerebral hemorrhage (ICH) is linked to poorer patient outcomes.
• Autonomic dysfunction, characterized by reduced heart rate variability (HRV), is common after brain injury.

Purpose of the Study:

• To investigate the association between heart rate variability (HRV) and the development of fever in patients with ICH.
• To determine if HRV can serve as an early marker for fever in ICH patients.

Main Methods:

• Prospective observational study of consecutive spontaneous ICH patients.
• Electrocardiogram (EKG) for HRV (SDNN) measurement within 24 hours of admission.
• Temperature monitoring to define fever (≥38°C) and fever burden within 14 days.

Main Results:

• Lower HRV (SDNN) was significantly associated with fever occurrence (p=0.001).
• Reduced HRV correlated with a higher number of febrile days (R=-0.22, p<0.001).
• Lower HRV independently predicted increased odds of fever after adjusting for other factors (OR 0.92, p=0.002).

Conclusions:

• HRV measured via EKG may serve as an early indicator of parasympathetic nervous system dysfunction after ICH.
• Identifying early parasympathetic dysfunction could enable targeted therapies to prevent fever and improve ICH outcomes.